The Social Construction of Identity in HIV/AIDS Home-based Care Volunteers in Rural KwaZulu-Natal; South Africa

Home-based care volunteer (HBCV) identity and how it is shaped was the main focus of the study. Fifteen HBCVs were interviewed about their work and personal life stories and then interviewed reflectively using a narrative interviewing style. Specific attention was paid to contextual meta-narratives and social field narratives in understanding the women's stories. Findings indicate that social field narratives of the women's stories were dominated by negative aspects of gender; poverty and socio-political factors. These were seen to coincide with the 'feminisation of responsibility' in this context effectively coercing the women into agency which manifested as their home-based care work. Meta-narratives influencing the women's lives were dominated by stories of communal motherhood; aspirations to service-oriented work and religious beliefs and commitment. The question of how it is possible for women who are seemingly constrained by oppressive narratives to voluntarily engage in community participation was answered in the women's personal life stories about being compassionate; hopeful; helpful and ambitious and having initiative. These characteristics collectively pointed to personal agency. Exploring connections between the different aspects of identity and context revealed that the women made sense of their community participation through their personal identities as strong and loving mothers. Connections between volunteer personal identity; agency and volunteer group identity were explored to make sense of the link between HBCV identity and volunteerism. The mother identity; encompassing personal agency (strength or power) and love (the meta-narrative of communal motherly love); was salient in influencing community participation of the group

The treatment action campaign and the three dimensions of lawyering: Reflections from the rainbow nation

The spread and perpetuation of the HIV/AIDS epidemic in South Africa has hindered the country's social and economic growth after apartheid. This paper documents my experiences while working with the Projects Abroad Human Rights Office and specifically my interactions with the Treatment Action Campaign (TAC); an organization which has taken a multidimensional approach in order to educate people about HIV/AIDS and attempt to provide access to medicines for millions of South Africans afflicted with the disease. I discuss how TAC has used both traditional and non-traditional methods of advocacy to combat the epidemic and equate access to health care to a social justice issue by empowering marginalized communities. The paper's dual purpose is to applaud TAC's continuous success in combating HIV/AIDS with such a multidimensional approach and illustrate how other organizations can utilize such an approach in order to affect social change. To illustrate TAC's approach; I utilize Lucie White's three dimensions of lawyering and equate TAC to a single cause lawyer; signifying that White's characterization of multi-dimensional activism is not limited to individuals; but can rather be applied at the firm level. White's three dimensions include: (a) advocacy through litigation; (b) advocacy in stimulating progressive change; and (c) advocacy as a pedagogic process. From this analysis; I conclude that TAC's multi-dimensional approach and specifically its inherent practice of White's three dimensions has been the root of its success in educating millions about the virus and advocating for access to medicines for those who have contracted HIV. TAC's innovative advocacy has also mobilized a new generation of South African activists who have helped TAC grow into a vibrant and integral organization within the country's post-apartheid culture. Such an example can serve as a framework for future organizations who wish to tackle other challenges that face the country

Hearing community voices: grassroots perceptions of an intervention to support health volunteers in South Africa

With the scarcity of African health professionals; volunteers are earmarked for an increased role in HIV/AIDS management; with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS - as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. Given the growing emphasis on involving community voices in project research; we conducted 17 discussions with 34 community members; including those involved and uninvolved in project activities - at the end of this 3-year period. These discussions aimed to elicit local people's perceptions of the project; its strengths and its weaknesses. Community members perceived the project to have made various forms of positive progress in empowering volunteers to run a more effective home nursing service. However; discussions suggested that it was unlikely that these efforts would be sustainable in the long term; due to lack of support for volunteers both within and outside of the community. We conclude that those seeking to increase the role and capacity of community volunteers in AIDS care need to make substantial efforts to ensure that appropriate support structures are in place. Chief among these are: sustainable stipends for volunteers; commitment from community leaders and volunteer team leaders to democratic ideals of project management; and substantial support from external agencies in the health; welfare and NGO sectors